Disparities in access to family physicians among transgender people in Ontario, Canada

Ayden I. Scheim, Xuchen Zong, Rachel Giblon, Greta R. Bauer

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background: Informed by the Gelberg-Andersen behavioral model for vulnerable populations, this study examined the prevalence of and factors associated with not having a family physician among transgender (trans) people in Ontario, Canada. Methods: Data were drawn from a respondent-driven sampling (RDS) survey of trans Ontarians age 16 and above (n = 433) conducted between 2009 and 2010. All analyses were weighted using RDS II methods. Prevalence ratios were estimated using average marginal predictions from logistic regression models. Results: An estimated 17.2% (95% CI, 11.0 to 22.9) of trans Ontarians (median age = 28.7, 77.3% White) did not have a regular family physician. In multivariable analyses accounting for other predisposing and need-related factors, transfeminine persons (trans women and non-binary persons assigned a male sex at birth) who were Indigenous and/or persons of color were less likely than other transfeminine persons to have a family doctor. In addition, trans persons who were homeless or had unstable housing were less likely to have a family doctor than those who were adequately housed. Conclusions: These results provide the first quantitative evidence of health disparities by race and gender within a Canadian transgender population and suggest a social gradient in access to care within Ontario's “universal health insurance” system.

Original languageEnglish (US)
Pages (from-to)343-352
Number of pages10
JournalInternational Journal of Transgenderism
Issue number3
StatePublished - Jul 3 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 Taylor & Francis Group, LLC.


  • Community-based participatory research
  • health services accessibility
  • intersectionality
  • primary health care


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